BECOMING A TRAINING PRACTICE WITH EV INFORMATION DOCUMENT

BECOMING A TRAINING PRACTICE WITH EV INFORMATION DOCUMENT

Introduction The Australian General Practice Training (AGPT) Program requires that where a general practice registrar is providing medical services, the Royal Australian College of General Practitioners (RACGP) or the Australian College of Rural and Remote Medicine (ACRRM) must accredit the relevant post. Responsibility for undertaking the accreditation process for supervisors and training practices has been delegated by the colleges to regional training organisations, such as Eastern Victoria General Practice Training (EV). All EV training posts are assessed against RACGP and/or ACRRM Training Standards: http://www.racgp.org.au/education/rtp/vocational-training-standards/ and http://www.acrrm.org.au/training-towards-fellowship/training-yourregistrars/supervisors-and-teaching-posts As such each placement must demonstrate how it meets and continues to meet all applicable standards. EV has developed an accreditation process to meet the requirements of the colleges. The GP supervisor/s and the training practice are deemed suitable for registrars (doctors in training) preparing for Fellowship of the RACGP or ACRRM once they have successfully completed this process. Training practices host GP registrars for any of their terms. Training practice accreditation is granted for a three-year term. Each practice seeking to maintain its accreditation status must, near the expiration of that term, apply to be reaccredited. Ongoing accreditation and eligibility to take registrars is dependent upon the practice continuing to meet the training standards of the colleges and EV training requirements. These are outlined in this document. Page 1 of 9

What is General Practice Training? The AGPT Program is a 3-4 year program. Some of the training time is spent in hospital gaining valuable skills there while the remainder is spent in supervised general practice. The program is delivered by training organisations such as EV and overseen by the Department of Health. The standards and requirements for training and assessments are set by the colleges. Australian General Practice Training Program (AGPT) Department of Health (DoH) Colleges Royal Australian College of General Practitioners (RACGP) Australian College of Rural and Remote Medicine (ACCRM) Regional Training Organisations e.g. EV deliver training program in regional areas Completion of Training Exams and assessments Sets standards for training practices and regional training organisations FELLOWSHIP RECOGNITION BY MEDICARE AS A GENERAL PRACTIONER FOR PATIENT REBATES Fellowship of the RACGP is a three year program while ACRRM is four years. Registrars who complete RACGP fellowship can also complete a fourth year to gain extra rural qualifications (FARGP). The two college pathways to fellowship are depicted below: Page 2 of 9

Year of training RACGP Qualification ACRRM Qualification* First year Hospital Core clinical Training time Second year GPT1 and 2 (6 month terms) Primary rural and remote training Third Year GPT3 and Extended skills (6 month terms) Primary rural and remote training Fourth Year Advanced rural skills training (Optional) Advanced specialised training Being a GP supervisor can be a rewarding and fulfilling experience. Many GP supervisors enjoy the opportunity to be involved in the training of the next generation of doctors. Registrars often bring new ideas and enthusiasm into a practice. Some elect to stay on or return to a practice after they have completed training. Being a GP supervisor can also be demanding and requires keeping up to date with changes in technology as well as the changes in general practice. Supervisors are supported in their role through the EV supervisor professional development program along with educational resources to help with the practice-based supervision and teaching. Becoming a training practice with EV There are a number of considerations in becoming a training practice. Firstly, do you and your practice have the qualities required to offer a good training environment and secondly, are you able to meet the requirements for being a training practice? The qualities of a good supervisor Full unrestricted medical registration Vocational recognition Some experience in teaching Fellowship is preferred Be willing to supervise and be involved in the education of GP registrars Be willing to attend professional development workshops as required by EV and the training standards A doctor taking responsibility for the supervision of GP registrars at all stages of their term should display the following attributes: Page 3 of 9

be known, approachable and easily accessible to the GP registrar and have established a rapport with them early in their placement be a good communicator be an advocate for the GP registrar understand the GP registrar s role in terms of experience of general practice be supportive of the GP registrar be able to adopt a counseling role with the GP registrar in relation to career or vocational planning and dealing with work pressures be interested in education, enjoy and be enthusiastic about teaching be able to deal effectively and assertively with other staff and specialists that the GP registrar will need to deal with The qualities of a good training practice AGPAL or GPA accreditation Clinically managed by GPs Friendly and encouraging environment Have space where the GP registrar can consult from Provide support to the GP registrar including practice staff and administrative support Provide adequate facilities such as o computers, internet access, journals etc o tea room and lunch facilities o access to required medical equipment Provide suitable working hours for the GP registrar A suitable patient load should be available for the GP registrar as well as access to a suitable variety of patient groups Accessibility to allied health and specialist care What is required of training practices? As a training practice, there are certain requirements that need to be met: Teaching: You will be expected to provide teaching to your GP registrar. The amount of dedicated teaching time depends on the level of experience of the registrar. Please see Appendix A: In-practice Teaching Requirements. Supervision: Supervision requirements are dependent upon the level of training of the registrar. It will be between 25% - 100% on site supervision and the rest will be offsite. More than one GP can provide this, once they are accredited. These requirements must be met by accredited supervisors but the teaching requirements may be met by anyone in the practice as long as the process is overseen by the principal supervisor. Please see Appendix B: Supervision Requirements. Supervisor Professional Development (PD): All supervisors are required to complete ongoing PD in supervision and teaching. New supervisors are those in their first three years of becoming accredited. EV requires that they must attend the New Supervisor Core Workshops, unless given an exemption (please see below). There are eight workshops in total, two of which are completed as part of the accreditation process. The other six form core workshops that are to be successfully completed over a three-year period. Once completed the practice and supervisors are considered established. They are then asked to attend professional development on an ongoing annual basis. o Exemptions: Prospective GP supervisors who have been accredited supervisors or medical educators in the past can apply for an exemption from the Core Workshops including the initial workshops. They must Page 4 of 9

complete an RPL (Recognition of Prior Learning) for Supervisors application. The completed application is submitted to the Accreditation Panel for consideration. If the response indicates a sound working knowledge of the objectives delivered at the New Supervisor Core Workshops they are granted an exemption and are then considered to be an experienced GP supervisor. In this setting they are required to attend professional development but do not have to complete all the core workshops. Administrative requirements: All practices are required to submit invoices for payment and information about the teaching provided within the practice to EV. In addition, there are certain activities such as the provision of feedback and completion of formal feedback that is required on a regular basis. Payment and conditions Funding is available to practices for Teaching and supervision of GP registrars Attendance at GP Supervisor Professional Development Workshops The funding is detailed in the practice agreement between EV and the training practice. Employment of Registrars AGPT (as part of the Department of Health) requires all registrars to be employees of the practice. All practices need to comply with the National Terms and Conditions for the Employment of Registrars. This document can be found at: http://gpsupervisorsaustralia.org.au/ntcer/ Page 5 of 9

The Accreditation Process The accreditation process for new practices involves a series of steps: Expression of interest EoI application submitted EV Accreditation Panel discuss application Preaccreditation Application for accreditation submitted Attendance at two initial workshops Practice visit Accreditation Report submitted to Accreditation Panel Practices monitored regularly by EV Completion of an Expression of Interest form. This includes information about the practice and motivation for becoming a training practice. An expression of interest is presented to the EV Accreditation Panel to assess whether or not it meets their requirements. This will depend on a number of factors such as: o Location of the practice (If the practice is in a required location) o Patient Profile (If the practice meets a required patient profile) o Special interests (If the practice has a required special interest profile) o If the practice and its doctors appear to meet RACGP/ ACRRM requirements If assessed as meeting the EV and RACGP/ACRRM requirements then an application form is sent to, and completed by, the practice. All supervisors need to complete two pre-accreditation workshops; there is an option for one of these to be completed online but the other is a face-to-face workshop. The topics are: o Having a Registrar in Your Practice o Giving Feedback and Assessing Competence Information regarding these workshops is sent to the practice once the application form is received. If the prospective supervisor has been an accredited supervisor or medical educator in the past*, they can apply for an exemption from the Core Module Workshops including the initial workshops. Upon completion of the workshops, a practice visit is arranged to discuss the placement and the practice. The visit includes: o o o o Tour of the premises including discussion of available resources and allied health Discussion with the practice manager regarding their understanding of GP Training and managing the registrar s training requirements Discussion with the prospective Principal Supervisor Discussion, if applicable, with the prospective Additional Supervisor/s A report is written by the accreditation visitor and this is presented to the Accreditation Panel. If approved by the Panel, accreditation is granted for three years. If not approved, the practice is notified by the Accreditation Panel with reasons for the decision. Page 6 of 9

EV reviews all new practices after they have had two registrar placements and the ongoing placement of registrars depends on practices meeting the requirements of training. At the completion of three years, the practice can apply for reaccreditation. All practices and supervisors are monitored on an ongoing basis to ensure that they are meeting the RACGP and/or ACRRM standards. *an accredited RACGP or ACRRM supervisor or a GP Medical Educator not longer than 5 years ago For further information please refer to: 1. The RACGP Vocational Training Standards http://www.racgp.org.au/education/rtp/vocational-training-standards/ 2. The ACRRM Standards http://www.acrrm.org.au/training-towards-fellowship/training-yourregistrars/supervisors-and-teaching-posts Contact Details: For further advice, please contact: Practice and Supervisor Support Officer - General: Pauline Gunn pauline.gunn@evgptraining.com.au Phone 9815 9511 Practice and Supervisor Support Officer - Rural: Linda Kruger linda.kruger@evgptraining.com.au Phone 5132 3103 Practice and Supervisor Support Coordinator: Dr. Judith Culliver judith.culliver@evgptraining.com.au Phone: 9815 9517 Page 7 of 9

Appendix A In-practice teaching requirements The following is a guide enabling you and your practice to meet teaching requirements which depend on the region in which the program is delivered as well as the level of training. As the principal supervisor you are entrusted with the education of registrars; you can perform this task alone, or in conjunction with other members of your practice team, however your role is to coordinate this. At least one hour of the time must be protected face to face teaching as outlined in the table below. Teaching may include: Orientation to the practice Registrar sitting in on supervisor s consultations Supervisor sitting in on registrar s consultations Case discussion / record review Demonstration of procedures / observation of registrar Video debriefing of consultations Formal tutorials Joint nursing home and home visits Discussion of ReCEnT report or Learning Needs Analysis Term FTE Hours per week 1.00 0.75 0.50 GPT1/PRR1 (1 hr protected) 3.00 2.25 1.50 GPT2/PRR2 (1 hr protected) 1.50 1.00 1.00 GPT3/PRR3 (projected) 0.75 0.75 0.75 ESP (GP)/PRR4 0.00 0.00 0.00 Teaching forms part of the registrar s usual working hours and is part of their paid employment. For part-time registrars, it is pro-rata with the exception of GPT3 registrars in the Melbourne program. Joint Educational Sessions (i.e. more than one registrar): each registrar will have individual learning needs and it is worthwhile discussing this early in the term. This may change throughout the term, so regular review would be valuable. Hence joint teaching can occur some of the time but it must always meet the registrar s learning needs. Page 8 of 9

Appendix B Supervision requirements General practice training is based around the model of on the job training where access to timely assistance is vital. The level of onsite supervision will depend on the competence and level of training of the registrar and the context of the training post. Supervisors need to make an assessment of the level of competence of their registrars and match the level of onsite supervision appropriately but this is usually between 25% - 100% on-site and the remainder will be off-site (i.e. by phone). More than one GP can provide this, providing they are accredited. EV requires the following minimum levels of supervision: Term Onsite Availability Availability by phone GPT1/PRR1 First month 100% consulting time Not applicable GPT1/PRR1- remainder 80% 20% GPT2/PRR2 50% 50% GPT3/PRR3 25% 75% ESP/PRR4/Elective 25% 75% When not on site, the principal supervisor must be available by phone or ensure that an accredited supervisor is available on site or by phone 100% of the time. Arrangements for leave Arrangements for the teaching and supervision of a registrar when a supervisor is on leave are the responsibility of the principal supervisor but an accredited supervisor needs to be onsite to meet the supervision requirements. In a multi-supervisor practice, there should be no disruption to supervision or teaching. In a single supervisor practice, if the accredited supervisor is to be away and there is no other accredited supervisor to take their role, the registrar will need to be on leave at the same time. This should be discussed with and agreed to by the registrar at interview and included in the contract between practice and registrar. Page 9 of 9